Pharm 3.0 Final
A nurse is preparing to administer Digoxin 0.2 mg via IV bolus to a client. The amount available is Digoxin 0.25 mg/1ml. How many ml should the nurse administer?
0.8 ml
A nurse is administering insulin glulisine 10 units subcutaneously at 0730 to an adolescent client who has type 1 diabetes mellitus. The nurse should anticipate onset of action of the insulin at which of the following times?
0745 short onset of action of 15 mins
A nurse is preparing to administer codeine 30 mg PO every 4 hr. PRN to a client for pain. The amount available is codeine oral solution 15 mg/5 ml. How many ml should the nurse plan to administer per does?
10 ml
A nurse is preparing to administer heparin 900 units/hr. via IV infusion. The amount available is heparin 25, 000 units in 500 mL 5% dextrose in water. The nurse should set the IV pump to deliver how many mL/hr.?
18 ml/hr
A nurse is preparing to administer Chlorothiazide 20 mg/kg/day PO divided equally and administered twice daily for a toddler who weighs 28.6 lb. The amount available is Chlorothiazide oral suspension 250 mg/5ml. how many ml should the nurse administer per dose?
2.6 ml
A nurse is preparing to administer ampicillin 500 mg in 50 ml of dextrose 5% in water [D5W] to infuse over 15 minutes. The drop factor of the manual IV tubing is 10 gtt./ml. The nurse should set the manual IV infusion to deliver how many gtt./min?
33 gtt/min
A nurse is preparing to administer dextrose 5& in 0.45% sodium chloride 400 ml IV to an older adult client over 8 hr. The nurse should set the IV pump to deliver how many ml/hr.?
50 ml/hr
A nurse is preparing to administer an IV fluid bolus of 1 L 0.9% sodium chloride over 2 hr. to a client who is dehydrated. The nurse should set the IV pump to deliver how many ml/hr.?
500 ml/hr
A nurse is preparing to administer ampicillin 50 mg/kg/day PO divided into 4 equal doses for a toddler who weighs 33 lbs. available is ampicillin 125 mg/5ml oral solution. How many ml should the nurse administer per dose?
7.5 ml
A nurse is preparing a discharge teaching plan for a 6-year-old client who has asthma and several prescription medications using metered dose inhalers [MDIs]. Which of the following interventions should the nurse include in the plan?
Add a spacer to the MDI MDI are difficult to use correctly and, even when properly used, only a portion of the medication is delivered to the lungs. spacer can make up for lack of hand-lung coordination by increasing the amount of medication delivered to the lungs.
A nurse is preparing to administer iron dextran IV to a client. Which of the following actions should the nurse plan to take?
Administer a small test dose before giving the full dose serious adverse effect is anaphylaxis caused by hyper sensitivity. test dose given over 5 min before giving full dose
A nurse is providing teaching to the parents of a school-age child who has asthma about medications for bronchospasm. Which of the following inhaled medications should the nurse instruct the parents to use to relieve and acute asthma attack?
Albuterol short acting beta2 adrenergic agonist that is used to provide immediate relief for an acute asthma attack. 1-2 puffs every 4-6 hr
A nurse is caring for a client who has a positive tuberculin skin test and is beginning a prescription for Isoniazid. The nurse should teach the client that which of the following laboratory values should be monitored while taking Isoniazid?
Aspartate Aminotrasnferase [AST] isoniazid can be toxic to the liver. it is important to monitor iver enzymes, such as AST, during therapy with isoniazid. the nurse should instruct the client to notify the provider of jaundice, nausea, dark-colored urine or other findings indicating hepatitis.
A nurse is planning to administer Diphenhydramine 50 mg via IV bolus to a client who is having an allergic reaction. The client has an IV infusion containing a medication that is incompatible with diphenhydramine in solution. Which of the following actions should the nurse take?
Aspirate to check for IV patency before administering the Diphenhydramine it is important to confirm IV patency prior to administering an IV bolus. some meds cause severe tissue damage when inadvertently administered into tissue rather than into a vein.
A nurse is caring for a client and realizes after administering the 0900 medications that she administered digoxin 0.25 mg PO to the client instead of the prescribed digoxin 0.125 mg PO. Which of the following actions should the nurse take first?
Assess the client's apical pulse priority-setting framework
A nurse is providing teaching to a client who has hypertension and a new prescription for oral Clonidine. Which of the following instructions should the nurse include in the teaching?
Avoiding driving until the client's reaction to the medication is known can cause drowsiness, weakness, sedation, and other CNS effects.
A nurse is planning to administer epoetin alfa to a client who has chronic kidney failure. Which of the following data should the nurse plan to review prior to administration of this medication?
Blood pressure epoetin alfa often causes hypertension, which can lead to stroke or other cardiovascular complications. monitor clients bp and notify the provider about increases. pt with use of this med also frequently requires concurrent use of antihypertensive meds.
A nurse is planning discharge teaching for a client who has Major Depressive Disorder and a new prescription for Phenelzine. Which of the following foods should the nurse include in the plan as safe for the client to consume while taking Phenelzine?
Broiled beef steak antidepressant. this med interacts with variety of foods to produce a hypertensive crisis. beef steak and other meats that are fresh do not interact with phenelzine and are safe to consume. most cheeses except cottage cheese and cream cheese interact with med pepperoni, salami, and other dried cured meats interact with maoi's smoked salmon: fish that has been cured or dried interacts with med
A nurse is providing discharge teaching to a client who has venous thrombosis and a prescription for warfarin. Which of the following instructions should the nurse include in the teaching?
Carry a medic alert ID card client who is taking warfarin is at increased risk for bleeding.
A nurse is caring for a client who has congestive heart failure and is taking digoxin. The client reports nausea and refused to eat breakfast. Which of the following actions should the nurse take first
Check the client's apical pulse. nausea, anorexia, fatigue, visual effects, and cardiac dysrhythmias, often caused by a slow pulse rate, are possible findings in digoxin toxicity. caring for this client requires applications of the nursing process priority-setting framework.
A nurse is caring for a client who has alcohol use disorder and is admitted with lower extremity fractures following a motor-vehicle crash. A few hours after admission, the client develops restlessness and tremors. Which of the following medications should the nurse anticipate administering to the client first?
Chlordiazepoxide long-acting oral benzodiazepine first line med for clients who are experiencing acute alcohol withdrawal. for pt who are nauseated or vomiting, another benzo like lorazepam can be administered.
A nurse is administering Ciprofloxacin and Phenazopyridine to a client who has a severe urinary tract infection [UTI]. The client asks why both medications are needed. Which of the following responses should the nurse make?
Ciprofloxacin hydrochloride treats the infection, and the phenazopyridine treats pain. cipro is a broad spectrum quinolone antibiotic and phenazopyridine is a bladder analgesic/anesthetic that relieves burning and pain in the bladder mucosa
A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the nurse instruct the client to expect?
Dry mouth antocholinergic properties aka dry mouth. client should take sips of water or suck on hard candies
A nurse is administering Adenosine via IV bolus for a client who has developed paroxysmal atrial tachycardia. For which of the following findings should the nurse assess the client during administration of Adenosine?
Dyspnea can occur during administration of adenosine due to bronchoconstriction. since adenosine has a very short half-life of about 10 seconds, this effect should be short-lived.
A nurse is planning to administer Diltiazem via IV bolus to a client who has atrial fibrillation. When assessing the client, the nurse should recognize that which of the following findings is a contraindication to administration of Diltiazem.
Hypotension Diltiazem can be treatment option for essential hypertension. this med will lower BP. should teach pt to self-monitor bp and keep record of the readings
A nurse is providing discharge teaching to a client who had a kidney transplant and has a prescription for oral cyclosporine. Which of the following statements by the client indicates an understanding of the teaching?
I am likely to develop higher blood pressure while taking this medication half the clients who take cyclosporine develop a 10% to 15% increase in blood pressure and might need to start antihypertensive therapy.
A nurse is providing discharge teaching about lithium toxicity to a client who has a new prescription for lithium. Which of the following statements by the client indicates an understanding of the teaching?
I can develop lithium toxicity if i experience vomiting or diarrhea vomiting and diarrhea can cause electrolyte imbalances. if serum sodium decreases, lithium is retained by the kidneys and the risk for lithium toxicity increases.
A nurse is providing teaching to a client who has hypertension and type 1 diabetes mellitus and a new prescription for metoprolol. Which of the following statements by the client indicates an understanding of the teaching?
I might have difficulty recognizing when my blood sugar is low metoprolol treats hypertension. is decreases heart rate, this is common manifestation of hypglycemia and can be masked and hypoglycemia might become hard to recognize.
A nurse is providing discharge teaching to a client who has been hospitalized for major depressive disorder and has a prescription or Amitriptyline. Which of the following statements by the client indicates an understanding of the teaching?
I will move slowly when I stand up because amitriptyline can cause my blood pressure to decrease
A nurse is providing teaching to a client who has postmenopausal osteoporosis and a new prescription for intranasal calcitonin-salmon. Which of the following statements by the client indicates an understanding of the teaching?
I will need to depress the side arms to activate the pump the nurse should instruct the client to activate the pump on the initial use by holding the bottle upright and depressing the two white side arms toward the bottle six times.
A nurse is providing teaching to a client who has heart failure and is taking Spironolactone. Which of the following statements by the client indicates an understanding of the teaching?
I will watch for increased breast tissue growth while taking this medication med is derived from steroids, can cause adverse endocrine effects, such as gynecomastia, impotence in men and irregular menses and hirsutism in women.
A nurse is caring for a client who is in preterm labor and has a new prescription for Nifedipine. The client states she is concerned because her father takes Nifedipine for his angina pectoris. The nurse should explain to the client that Nifedipine works for clients who are pregnant by which of the following mechanisms?
It inhibits uterine contractions by blocking entry of calcium into uterine cells nifedipine, calcium channel blocker, causes uterine relaxation by blocking the flow of calcium to the myometrial cells of the uterus.
A nurse is providing teaching to a client who has type 2 Diabetes Mellitus and a new prescription for Metformin. Which of the following adverse effects of Metformin should the nurse instruct the client to watch for and report to the provider?
Myalgia myalgia, malaise, somnolence, and hyperventilation are manifestations of lactic acidosis, which rarely occur while taking metformin due to blockage of lactic acid oxidation.
A hospice nurse is caring for a client who has cancer and is taking naproxen 250 mg three times daily PO and gabapentin 1,800 mg three times daily PO to manage pain. The client tells the nurse, "I'm having pain that keeps me from doing what I'd like most of the time." Which of the following additions should the nurse anticipate to the client's medication regimen?
Oral Oxycodone current pain regime consists of a nonopioid analgesic, naproxen, and an adjuvant med for neuropathic pain, gabapentin.
A nurse is caring for a client who was brought to the emergency department by friends who report the client has overdosed on heroin. Which of the following findings should the nurse expect to assess?
Pinpoint pupils expected finding in opioid toxicity. increased pupil size is seen in opioid withdrawal.
A nurse is monitoring laboratory values for a male client who has leukemia and is receiving weekly chemotherapy with methotrexate via IV infusion. Which of the following laboratory values should the nurse report to the provider?
Platelets 78,000/mm monitor the platelet count of a client who is asking methotrexate because the med can cause thrombocytopenia
A nurse is preparing a discharge teaching plan for a client who is to being long-term oral prednisone for asthma. Which of the following instructions should the nurse include in the plan?
Schedule the medication on alternate days to decrease adverse effects some adverse effecs caused by long-term glycocorticoid therapy, such as suppression of the adrenal gland, can be avoided by using alternate-day therapy.
A home health nurse is visiting an older adult client who has Alzheimer's disease. His caregiver tells the nurse she has been administering prescribed Lorazepam, 1 mg three times per day, to the client for restlessness and anxiety during the past few days. For which of the following adverse effects should the nurse assess the client?
Sedation benzodiazepine with anti-anxiety and sedative effects. older adults are at risk for CNS depression even with low doses of benzodiazepines.
A nurse is teaching a client who has chronic stable angina pectoris and a prescription for sublingual nitroglycerin tablets. Identify the sequence of instructions that the nurse should tell the client to use if he experiences chest pain?
Stop activity, place a tablet under the tongue, wait 5 minutes, call 911 if the pain is not relieved
A nurse is planning care for a female client who has severe irritable bowel syndrome with diarrhea [IBS-D] and a new prescription for Alosetron. Which of the following interventions should the nurse include in the plan of care?
The client must sign an agreement with the provider before beginning alosetron this med can have potential fatal adverse effects associated with constipation and bowel obstruction
A nurse is providing teaching to a client who is to start taking Hydrochlorothiazide for hypertension. The nurse instructs the client to eat foods rich in potassium. Which of the following statements by the client indicates an understanding of the teaching?
This medication can cause a loss of potassium diuretic hypokalemia caused by excessive potassium excretion by the kidneys. the client should supplement his diet with potassium-rich foods to avoid the occurrence of hypokalemia. Bananas, raisins, baked potatoes, pumpkins, and milk.
A nurse is caring for a client who has heart failure and is taking oral furosemide 40 mg daily. For which of the following adverse effects should the client be taught to monitor and notify the provider if it occurs?
Tinnitus
A nurse is caring for a client who has heart failure and is taking oral furosemide 40 mg daily. For which of the following adverse effects should the client be taught to monitor and notify the provider if it occurs?
Tinnitus loop diuretics can cause ototoxicty. flient should be taught to notify the provider if tinnitus, a full feeling in the ears, or hearing loss occurs.
A nurse is assessing a client who has oral Theophylline for relief of chronic bronchitis. The nurse should recognize that which of the following findings indicates toxicity to Theophylline?
Tremors theophylline is an xanthine derivitive bronchodilator. an early manifestation of toxicity is CNS stimulation, often seen as tremors. seizures can occur if blood levels continue to rise.
A nurse is assessing a client who reports using several herbal and vitamin supplements daily, including saw palmetto. The nurse should recognize that saw palmetto is a supplement used by clients to elicit which of the following therapeutic effects
Urinary health promotion Saw Palmetto is used primarily for manifestations related to prostatic conditions, such as benign prostatic hypertrophy (BPH). Its effectiveness has not been scientifically proven, however. the nurse should teach the client to check with the provider about interactions between saw palmetto and other medications.
A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the client reports that she has been taking extra doses to promote weight loss. Which of the following findings should indicate to the nurse that the client is dehydrated?
Urine specific gravity 1.035 Oliguria, increased urine concentration, and increase in urine specific gravity greater than 1.030 are expected findings in clients who are dehydrated.
A nurse is providing discharge teaching to a client who has angina pectoris and a new prescription for verapamil. The client tells the nurse, "My brother takes verapamil for high blood pressure. Do you think the provider made a mistake?" Which of the following responses should the nurse make?
Verapamil is used to treat both high blood pressure and angina.
A nurse is providing discharge teaching to a client who had a bleeding duodenal ulcer and is prescribed Omeprazole. Which of the following statements should the nurse include in the teaching?
You should take this medication before breakfast every day take once a day before a meal (usually breakfast) med is less effective when taken with food.
A nurse is providing discharge teaching to a client who has heart failure and a prescription for Digoxin 0.125 mg PO daily and Furosemide 20 mg PO daily. Which of the following statements by the client indicates an understanding of the teaching?
i will eat fruits and vegetables that high potassium content every day hypokalemia is an adverse effect of diuretic therapy. maintain k level of 3.5-5.0 to avoid dig toxicity
A nurse is preparing to administer oxytocin to a client who is at 41 weeks of gestation and is experiencing ineffective labor. Which of the following actions should the nurse plan to take?
increase the dose of Oxytocin to obtain uterine contractions that occur every 2-3 minutes
Echinacea
popular herb widely used in the US primarily to reduce the manifestations and duration of colds and flu-like illnesses, although its effectiveness has not been proven.
Ginger root
sometimes used to prevent and treat nausea caused by motion sickness, and seasickness, and other causes.
A nurse is assessing a client who has hypothyroidism and takes Levothyroxine. Which of the following findings should alert the nurse that the client is experiencing acute Levothyroxine overdose?
tremors tremor and anxiety are expected findings in acute levothyroxine overdose. these are findings similar to hyperthyroidism.
Ginko biloba
widely used dietary supplement in US for increasing cognitive functions in elderly people, although this effect has not been proven, Ginkgo has been shown to improve leg pain of intermittent claudication and other peripheral arterial disorders.
